The disease caused by a violation of the structure of the walls of blood vessels, their thinning, with pronounced stagnant processes of blood flow, is called varicose veins. The disease often affects the lower extremities, although it can be localized to the rest of the body. According to the International Classification of Diseases of the Tenth Review of ICD 10, varicose veins are assigned code 183, which includes four titles describing different manifestations of the disease.
How did varicose veins appear?
The first mention of varicose veins was found in ancient Greek papyri. Confirmed history and scientific facts say that varicose veins of the lower extremities were found in the Egyptian mummy found - it could be argued that the disease accompanies humanity throughout its existence.
Prominent physicians - Avicenna, Hippocrates, Galen tried to treat varicose veins of the lower extremities. In the 19th century, painful and traumatic methods of treatment were used, which consisted of splitting the tissues of the thigh and lower leg to damage the saphenous veins, followed by bandaging. It was realized that in this way it is possible to prevent stagnant blood flow processes and varicose veins will be eliminated. However, the methods left horrible, extensive wounds on patients's bodies and contributed to damage to nerves, arteries and disruption of lymph flow.
Shortly afterwards, the history of treating varicose veins took a positive turn - in 1908, for the first time, a metal probe was used as a means of minimally invasive effect on the walls of blood vessels. The discovery of radiography made it possible to perform more accurate and efficient surgical operations to eliminate varicose veins. Now, when accurate diagnosis and treatment of the disease is needed, duplex and triplex scans, powerful drugs, laser therapy and sclerotherapy are used. Surgical intervention is used only in cases where varicose veins can not be eliminated en masse.
The main causes of the disease
Varicose veins are a big risk, the pathology has become "newer" - in the past, mostly the elderly suffered, now varicose veins are diagnosed in young patients, extremely rarely in children.
Causes of the disease:
- Genetic predisposition.
- Overweight, overweight, obesity.
- Sedentary sedentary lifestyle.
- Inadequate diet, poor blood quality.
- Concomitant diseases of the cardiovascular system.
- Professional activity.
- Prolonged posture, strenuous physical exercise.
- Pregnancy and hormonal changes.
- Individual characteristics of the structure of the vascular system.
- Congenital pathological diseases.
- Wearing high-heeled shoes, tight clothing.
- Thermal treatments.
Each of the above reasons can provoke the development of varicose veins, the consequences are dangerous, including death.
The structure of venous vessels
To understand what causes varicose veins of the lower extremities, you need to have an idea of the structure of the vascular system and the mechanism of its work. It represents the totality of the main veins (deep and superficial) and connective (communication).
The small superficial vein begins in the region of the foot, extends along the back of the lower leg, branches below the knee into two branches, connects to the popliteal vein, and the deep femoral vein.
A large superficial saphenous vein forms in the ankle region, runs along the surface of the lower leg and knee joint, and connects to the femoral vein. The deep veins are located along the branches of the arteries, and the entire venous system is connected by piercing vessels.
With normal blood flow, oxygenated blood flows directly to the heart, and special venous valves prevent reverse flow. Varicose veins of the lower extremities mean strong pressure, the diameter of the venous lumen increases significantly, the valves do not cope with the task, reflux occurs - reverse blood flow. Improper blood circulation provokes excessive expansion (stretching) of the walls of blood vessels, their thinning, venous obstruction and blood stasis. As a result - swelling, swelling of the veins, the formation of joints.
Symptoms and clinical presentation
Varicose veins are able to progress for a long time in a latent form, then the signs appear:
- The formation of spider veins is a network of small enlarged veins.
- Well-defined pattern of compressed veins protruding under the skin.
- Formation of sites of compression of blood vessels - varicose veins in the form of distinct tubercles in the legs.
- A change in normal skin color, cyanosis, darkness appears, the upper layer (dermis) acquires a loose structure.
- Feeling of pain, heaviness, stretching and fatigue of the legs, decreased mobility, difficulty walking.
- With varicose veins of the lower extremities, the formation of soft tissue swelling is possible.
Ignoring timely treatment leads to serious and dangerous consequences, when a person can only be cured with immediate surgical intervention.
Classification of diseases
Varicose veins according to ICD 10 are classified into a disease with ulcer, with inflammation, with ulcer and inflammation, when these signs are absent. According to the International Classification of Chronic Venous Diseases, established in 1994, varicose veins are classified into:
- Intradermal, segmental. No pathological venous discharge is observed.
- Segmental with reverse blood flow, occurs through superficial and perforating veins.
- Distributed by reverse blood circulation through superficial and perforating veins.
- Varicose veins with opposite blood flow through the deep veins.
Common duty to divide the disease according to the additional signs of the clinical picture:
- On examination or palpation, there are no symptoms.
- Reticular veins are expressed.
- There are varicose veins.
- There is soft tissue swelling.
- Violation of normal skin color.
- Detected lipodermatosclerosis.
- There is a healing ulcer.
- An active ulcer was detected.
Symptoms are absent or are subjective (patient feelings). Moreover, varicose veins are classified for reasons: congenital, primary, secondary, with an unknown factor that provoked the development of the disease.
Diagnosis of varicose veins
The predominant way to identify varicose veins is visual examination and palpation of the patient. To carefully determine the severity of the disease and to choose the right treatment, when you study the medical history and palpation is applied, the phlebologist describes:
- A complete blood count is the main standard for determining red blood cell count and hemoglobin level. According to the blood clot, conclusions are drawn about the degree of development of the disease and the predisposition to thrombosis.
- Doppler ultrasound. The method consists in ultrasound diagnosis of the velocity and direction of blood particles. This allows you to determine in which direction the blood flow takes place, if there is enough speed.
- Ultrasonic agnioscanning. Used for visual examination of vascular walls, their structure, direction and speed of blood flow in real time on the monitor of the ultrasound machine.
- Plethysmography. Diagnosis is based on the detection of electrical resistance of foot tissues. With proper circulation, the parameter should indicate the normal standard.
- Rheovasographic diagnosis. Based on the determination of tissue blood filling index. The rheographic index helps determine the stage of varicose veins - compensation, undercompensation or decompensation.
The history of the disease and its study, obtaining comprehensive diagnostic data, allow the physician to choose the method of treatment.
Conservative drug therapy
This method of treatment involves the appointment of special drugs that have a positive effect on the course of the disease. Conservative treatment of varicose veins is effective in the initial stages, used as an additional method of treatment in the formation of joints, ulcers, eczema.
The main groups of drugs prescribed are:
- Phlebotonics and phleboprotectors. Venotonic drugs are the standard, which means conservative treatment. Promote the restoration of the structure of blood vessel walls, strengthen and tone blood vessels.
- Means for effective blood thinning. They contribute to improving the quality composition, blood flows faster through the veins, reduces the risk of blood clots, restores normal blood circulation and relieves pain.
- NSAIDs (anti-inflammatory drugs). Eliminate pain, prevent cramps, effectively relieve inflammation and swelling.
Conservative treatment helps with timely referral to a phlebologist, in the initial stage it is possible to influence the composition of the blood and the condition of the walls of blood vessels. With complex forms of the disease, drastic measures are required.
Laser therapy
Laser therapy is known as a gentle and less traumatic method when varicose veins of the legs require treatment classified according to ICD 10 code 183. The idea of the method is to use a laser beam that actively affects the vascular walls and promotes adhesion ofAn LED connected to a laser device is inserted into a vein by piercing the skin. The beam is selective and has no effect on healthy adjacent tissues. Important advantages of laser therapy in the treatment of varicose veins:
- Fast positive effect.
- Lack of pain and injury.
- Lasting result, long-term forgiveness.
- Restoration of normal blood circulation.
Contraindications for use will be thick or very thin vessel walls, large venous lumens, pregnancy, oncology and other serious concomitant diseases.
Sclerotherapy for varicose veins
The method is based on the introduction into the vessels affected by varicose veins of special liquid or foam preparations - sclerosants. They replace endothelial cells with fibrous tissue. Needles, syringes, and sclerosants are used to perform sclerotherapy.
The treatment technique consists of the following steps:
- drilling of a pathological vein;
- pumping (removing) all blood from the vessel;
- administration of a sclerosing preparation;
- placing a suitable bandage or knitted compress.
This method gives a consistent result. The procedure is painless, fusion of vascular tissue with varicose veins is an alternative to surgery.
Performing an operation
The most painful and traumatic way to treat varicose veins is surgery. Indications for carrying out will be extensive vascular lesions, the presence of varicose veins, dangerous consequences of the disease, for example, acute thrombophlebitis.
Phlebectomy is performed under local anesthesia, the pathological vein is ligated, the required number of incisions are made to remove it, and they are removed. Surgery is known as an effective method of treatment, showing the result in eighty percent of cases. But phlebectomy has a number of side effects: wound complications, lymph node trauma, in extreme cases, with deep nerve damage, immobilization and disability can occur.
To prevent dangerous complications of varicose veins, which are manifested by: joints, ulcers, bleeding, phlebothrombosis, pulmonary embolism and other serious consequences, you should consult a doctor in the initial stage of varicose veins!